NPIMap

Organization Active NPI

Blue River Services, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Milltown, IN
National Provider Identifier
1184747313
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
BLUE RIVER SERVICES, INC.
Practice address
5771 E. Speed Rd
Milltown, IN 47145
Phone
(812) 365-2451
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel J Lowe
Title
President Ceo
Phone
(812) 738-2408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X IN Primary

Addresses

Primary practice location

5771 E. Speed Rd
Milltown, IN 47145

Mailing address

PO Box 547
Corydon, IN 47112-0547
Phone (812) 738-2408

Other identifiers 1

IdentifierTypeStateIssuer
100385530 AMedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Blue River Services Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5771 E Speed Rd
Milltown, IN 47145
Phone (812) 365-2451

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1184747313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471120547",
            "telephone_number": "812-738-2408",
            "fax_number": "812-738-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5771 E. SPEED RD",
            "city": "MILLTOWN",
            "state": "IN",
            "postal_code": "47145",
            "telephone_number": "812-365-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIVER SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT  CEO",
        "authorized_official_telephone_number": "812-738-2408"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100385530 A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milltown, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.